We carried out this announced inspection on 6 March 2019 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We planned the inspection to check whether the registered provider was meeting the legal requirements in the Health and Social Care Act 2008 and associated regulations. The inspection was led by a CQC inspector who was supported by a specialist dental adviser.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?

• Is it effective?

• Is it caring?

• Is it responsive to people’s needs?

• Is it well-led?

These questions form the framework for the areas we look at during the inspection.

Our findings were:

Are services safe?

We found that this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

We found that this practice was providing effective care in accordance with the relevant regulations.

Are services caring?

We found that this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found that this practice was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found that this practice was providing well-led care in accordance with the relevant regulations.

Background

Dr Simon Rixon Dental Practice Nuneaton provides private treatment to adults and children.

The practice is situated above a commercial business and is accessed up a flight of stairs. The practice informs all new patients wishing to register that unfortunately they are not wheelchair accessible and signpost patients that cannot manage the stairs to a nearby practice. There is a free car parking available in the streets surrounding the practice.

The dental team includes the principal dentist and one dental nurse. The practice has one treatment room.

The practice is owned by a company and as a condition of registration must have a person registered with the Care Quality Commission as the registered manager. Registered managers have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run. The registered manager at Dr Simon Rixon Dental Practice Nuneaton is the principal dentist.

On the day of inspection, we collected 39 CQC comment cards filled in by patients and spoke with one patient.

During the inspection we spoke with the principal dentist and the dental nurse. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday: from 9am to 1pm and from 2pm to 5pm.

Tuesday: from 9am to 1pm.

Wednesday: from 9am to 1pm and from 2pm to 5pm.

Thursday: from 9am to 1pm and from 2pm to 5pm.

Friday: from 9am to 1pm.

Our key findings were:

• The practice appeared clean and well maintained.
• The provider had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available with the exception of oropharyngeal airways and self-inflating bags with reservoirs. These items were ordered at the time of our visit.
• The practice had systems to help them manage risk to patients and staff. The practice did not have a rectangular collimator fitted to the X-ray machine, this was ordered and fitted following our visit.
• The practice had a safeguarding lead with effective processes in place for safeguarding adults and children living in vulnerable circumstances.
• There was a long-standing team which had worked together for over 30 years. The provider had thorough staff recruitment procedures which had not been used due to not needing to recruit staff in over 30 years.
• The clinical staff provided patients’ care and treatment mostly in line with current guidelines. Clinical records did not detail the risks and benefits of treatment options discussed with patients.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• Staff were providing preventive care and supporting patients to ensure better oral health.
• The appointment system took account of patients’ needs. Patients could access treatment and emergency care when required.
• The provider had effective leadership and culture of continuous improvement.
• The team consisted of the principal dentist and a dental nurse. We saw that they worked well together and supported one another.
• The provider asked staff and patients for feedback about the services they provided. Feedback from patients was overwhelmingly positive with patients advising that they had been attending this dentist for over 30 years. Several patients told us that they had moved out of the area, but chose to travel long distances to be seen here.
• The provider had not received any complaints, but had processes in place to deal with any should the need arise.
• The provider had suitable information governance arrangements.

There were areas where the provider could make improvements. They should:

• Review the practice's protocols for completion of dental care records taking into account the guidance provided by the Faculty of General Dental Practice.

During our inspection visit to this dental practice we spoke with both the dentist and the dental nurse. In order to gain the experiences of people who used the practice we also spoke with three people on the day of our visit and a further three people by telephone following our visit.

People told us that they were satisfied with the service they received at the practice. They told us that they felt included in their treatments and were kept well informed about their oral and dental health. "I'm very satisfied with the practice and the treatment I get" and "I wouldn't go if I didn't trust him" were comments made to us.

People told us that the practice was one they would recommend to friends and family making comments such as, "I've already recommended the practice to friends" and "It's a private practice, I would recommend him, he's very good, you feel safe with him."

People told us they were satisfied with the standards of hygiene at the practice. One person told us, "The hygiene is A1." We found that infection control practices were being maintained in line with national guidelines.

We found that records containing people’s confidential information was accurate, fit for purpose and stored securely.